Category: General

Although more significant weight loss may result in more benefits to the body, even losing > 2.5 % of weight can improve blood glucose and triglycerides. More considerable reductions ( say >10 %) would lead to improvements in sleep apnea and fatty liver. Significant weight loss ( > 15 kg loss ) can lead to remission of diabetes in many people with shorter disease duration. People who have undergone bariatric surgery and lost significant weight have seen improvements in heart disease and risk of death.

So, if you are a person with obesity and starting a weight loss program, congratulate yourself for every kilogram lost!

Childhood obesity is a major problem that can increase the risk of metabolic diseases like dyslipidemia, diabetes, hypertension and sleep apnea. Although various genetic causes can appear as obesity in childhood, most obesity in childhood is related to calorie excess on a background of genetic influences.

Although there are limited studies to address this issue, studies have shown that childhood obesity tracks into adulthood. For example, in a model that tracked obesity from 2 years to 35 years, the relative risk of obesity as an adult( at 35 years) was 1.3 times if you were obese at two years and 2 times if you were obese at 19 years. However, the converse is not true; not all people obese at 35 years were obese as children.

Hence it is essential to plan healthy diets and lifestyle changes in children.

Turner syndrome( TS) is a genetic ( not inherited ) condition. It is caused by a full or partial loss of the second female sex chromosome. Therefore, only females can have Turner syndrome. Girls with Turner syndrome are usually identified when they present with short stature or when their menstrual periods do not start on time. Most girls with Turner syndrome will have normal intelligence but may have social immaturity, attention-deficit disorder, and specific learning disabilities. Other distinctive physical features of Turner Syndrome include low-set ears, webbed neck (excess skin on the neck), scoliosis, and fingernails and toenails that turn upward. People with TS can also have problems with the heart, kidneys, thyroid and ears. However, they could look like any short, ordinary girl.

If you feel your child is not growing well, please seek care from an endocrinologist.

Because the signs of Turner syndrome are usually obvious, most girls with the condition are diagnosed shortly after birth or in early childhood. However, some women with Turner Syndrome look normal except that they are short in height. In addition, girls with more severe forms of Turner Syndrome may be diagnosed early, whereas others may not be diagnosed until adolescence when they don’t start their menstrual periods.

The test used to determine Turner syndrome is called a karyotype. A karyotype is a blood test that produces an image of your chromosomes. That way, your doctor can identify whether one of your sex chromosomes is missing or partially missing.

It is common to find that the condition is unidentified for many years before parents bring the kids to an endocrinologist.

Being a genetic condition, there are no cures for Turner syndrome. While there are no specific therapies for TS, there are many treatments to help them with their medical problems. Human growth hormone can help increase height in girls with TS. Girls with TS started early on growth hormones can achieve good height. Without growth hormone treatment, the average height of an adult woman with Turner syndrome is less than 5 feet. However, if treatment starts early and is maintained, girls with Turner syndrome can reach a near-normal height.

Like growth hormone, estrogen replacement therapy is a standard treatment for Turner syndrome. The purpose of estrogen therapy is two-fold—to prompt the body into beginning puberty and to maintain healthy sexual development and functioning throughout adulthood.

Estrogen replacement therapy will help manage pubertal problems of Turner syndrome. It is essential to identify these girls early enough, so their height improves with growth hormone therapy before they are started on estrogen. An endocrinologist can help you optimise both the height and puberty.

Women with TS have trouble conceiving naturally because they are susceptible to early ovarian insufficiency. This means that the ovaries of women with TS lack the capacity to produce both the hormone estrogen and the eggs required for fertility. Lack of estrogen results in lack of healthy development of female sex characteristics during puberty. Lack of egg production leads to infertility.

Though most women with Turner syndrome are infertile, some females may become pregnant with or without reproductive technology(E.g. IVF). People with TS may have many medical problems that need optimising before planning pregnancy. If you are a person with TS, please seek care from an endocrinologist before planning a fertility procedure.

Thyroid diseases are common in the community. It is essential to understand that many of these do not have symptoms, and some may not have significant health consequences. The prevalence of thyroid diseases may differ according to the ethnicity of the people where this was studied, the iodine intake of this population and their age. Around 10 % of people have mild or subclinical hypothyroidism, and about 4% have overt or symptomatic hypothyroidism. Hyperthyroidism is less common. About 1.6% of people have subclinical or mild hyperthyroidism, and 1.3 % have overt hyperthyroidism. If you look at the presence of Anti TPO antibodies, around 17% of people may have these. Many of these people may not have any thyroid dysfunction.

Around one in 100,000 men and around 1.8 in 100,000 women are newly diagnosed with thyroid cancer annually. The risk of thyroid nodules increases with age and is more seen in women and those with iodine deficiency or after radiation exposure. Depending on how you try to detect the nodules, around 20 to 40 % have thyroid nodules on ultrasound and about 5 % percentage when you feel it clinically. If you take women in pregnancy, about 2.5% of women may have hypothyroidism and around one to 4 out of 1000 women may have hyperthyroidism. Hence, thyroid diseases are widespread in the community, but not everyone requires treatment. If you are detected to have thyroid disease, you should meet an endocrinologist to sort it out.

There are various thyroid antibodies, the commonest being anti-TPO antibodies. Anti-TPO stands for anti-Thyroid Peroxidase. TPO is an enzyme in the thyroid gland that is important for synthesizing thyroid hormones and is present in everyone. Due to various reasons, the body develops an immune response against this TPO. The antibody so generated is called anti-TPO antibody. The elevated level of this antibody shows that the body has an immune attack against the thyroid.

Anti-TPO antibody is very common, and around 17 % of people have them. People with anti-TPO antibodies have a high chance of developing thyroid disease if they don’t already have it. They also have a chance of progression of thyroid disease if they already have a mild thyroid disease. Although there are scientific data associating anti-TPO antibodies with various medical problems like recurrent abortions and heart disease, there is no convincing proof that antibodies are responsible for this. Therefore, there is no role in treating anti-TPO antibodies if thyroid functions are normal.

So, the anti-TPO antibody is only a marker of autoimmune thyroid disease and not a disease. So don’t panic over high levels, and don’t keep repeatedly doing it.

Being told that a person has lumps or nodules in the thyroid can worry the patient. But there is no need to be concerned regarding thyroid nodules. Thyroid nodules are widespread, affecting more than half of the population above 60 years. Most thyroid nodules don’t have symptoms and are found incidentally. However, in other cases, the nodules can get big enough to cause problems.

The vast majority — more than 90% — of thyroid nodules are benign (noncancerous). However, if a concern arises about cancer, the doctor may recommend monitoring the nodule over time to see if it grows. Ultrasound is the test to evaluate and monitor the thyroid nodule and determine the need for a biopsy. If needed, a thyroid fine needle aspiration biopsy is done, and samples of cells from the nodule are examined under a microscope, which can provide your doctor with more information about the behavior of the nodule.

If a thyroid nodule is causing voice or swallowing problems, your doctor may recommend treating it with surgery to remove all or part of the thyroid gland. Even if a nodule turns out to be thyroid cancer, it is treatable. Surgery to remove the gland addresses the problem, and recurrences or spread of the cancer cells are uncommon.

There is no need to be worried about being diagnosed with a thyroid nodule. Instead, choosing an experienced specialist(endocrinologist)will help you get proper treatment.

Patients with hypothyroidism (low thyroid hormone levels) will require oral consumption of thyroid hormone (levothyroxine) daily. Dietary habits can influence how the body absorbs levothyroxine. Take levothyroxine once a day in the morning, ideally at least 30 -60 minutes before having breakfast or a drink containing caffeine, like tea or coffee. Food and caffeinated drinks can stop your body from absorbing levothyroxine properly, so it does not work either.

Certain medications and supplements decrease the absorption of thyroid hormone and should be taken 3-4 hours after taking thyroid hormone. These include

• Fiber supplements
• Calcium and iron supplements
• Proton pump inhibitors (omeprazole and pantoprazole)
• Multivitamins
• Soy products

Also, ensure that the medicine container is stored at room temperature, away from heat, moisture, and direct light. Keep from freezing.